28D0453562 CLIA NUMBER - HILLCREST SHADOW LAKE LLC DBA HILLCREST SHADOW LAKE

Laboratory Demographics

  • CLIA Code: 28D0453562
  • Facility Name: HILLCREST SHADOW LAKE LLC DBA HILLCREST SHADOW LAKE
  • Facility Address: 1507 GOLD COAST RD
    PAPILLION, NE
    ZIP 68046
  • Facility Phone: 402 339-6010
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CHRIS SOBRILSKY
  • NPI Number: 1245997436
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 28D0453562
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name HILLCREST SHADOW LAKE LLC DBA HILLCREST SHADOW LAKE
Street 1507 GOLD COAST RD
City PAPILLION
State NE
ZIP 68046
Phone 402 339-6010
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director CHRIS SOBRILSKY

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This page was last updated on: 9/29/2025